The views presented here are meant to be speculative, in order to address some well-known changes in views of the body in early modern Europe so as to remind us of materialist possibilities within what have tended to become histories of ‘culture’. The examples are taken from the history of medicine simply because that is a field I happen to know best, but the kinds of historical problems addressed through such examples will, I hope, speak to some elements of the general crisis historians currently face in making meaningful statements about the past. Perhaps more than in recent decades, the looming political, economic and ecological catastrophes of the moment are entangled in systems of production, exchange and coercion which exhibit the hard edges that sometimes seem to generate fear more than hope. At such moments, the double-meaning of ‘culture’ as a manifestation both of self-expression and collective behaviour seems to place it in the category of secondary effects, or to use an older terminology, of ‘superstructure’ built upon other foundations, the relationships of which call for analysis. The methods of historians, like others, have undoubtedly benefited enormously from the ethnographic turn, which has reminded us of the power of the forces that bind, even as our discipline has never lost sight of the materially real any more than anthropology, or art history, or other subjects that investigate the human. And yet, this seems an appropriate moment to advocate again the probing for connections between forms of culture and ways of living that are characterised as economic, so as to observe the effects of metal on flesh. The object of the inquiry is not to reject what we have learned about the power of culture, but to link it to other processes as well. The history of the body as viewed through transformations in medicine is an excellent vantage-point for such musings.

The account below therefore takes a situational approach to what has been considered by some to be a fundamental change in bodily perceptions: that is, it frames the changes in terms of a multitude of criss-crossing long-term trends and collective outlooks rather than in terms of causal chains. At the same time, many of the persons and events have an almost accidental relationship to one another, coming and going to form a narrative that is something more like a picaresque than a romance. Such accounts might well be knit together by referring to the culture in which they occurred. But other pressures had to do with commerce, for some kinds of articulations about the body were pressed on the public because they simplified treatments that used medicines that would have similar effects on anyone. In other words, moving from considerations of the body individual to the body universal had advantages in the medical marketplace.Footnote ¹

It is well known that over the past two or three decades, the history of the body has become a subject of much interest to historians of many kinds. Many of the descriptive and explanatory frameworks deployed in this literature have been guided by the kind of cultural studies which emerged from the debates of the late 1960s about how systems of power dominated their subjects without the need to resort to physical coercion, in which the views of Michel Foucault were formative. For instance, Barbara Duden's Geschichte unter der Haut (1987), translated into English in 1991 as The Woman beneath the Skin, was inspired by contemporary discourses about how general assumptions and even personal expectations were rooted in ways of life. While other historians of the time might have referred to Gramsci's ‘hegemony’, or employed Michel Foucault's episteme or the Annalists’ mentalité even more than she does, Duden also took much from both contemporary feminism and the circle around Ivan Illich (who was associated with Latin American liberation theology and found modern institutions such as state schooling and medicine to be disciplinary perversions of the authentic human spirit). But Duden also recruited support from sources such as the doctoral dissertation of Rudolph zur Lippe, which examined relationships between the geometrisation of space and body disciplines such as military drills, fencing and dancing.Footnote ² A student of Theodor Adorno's, it is not surprising that Zur Lippe himself intended to explore some of the ways in which the beginnings of capitalism changed the senses and experiences of Europeans.Footnote ³ From other perspectives, Roy Porter's reposts to Foucault also emphasised a social history giving special attention to the ordinary person's or patient's voice with the market very clearly involved.Footnote ⁴ In other words, there is much in early work on the history of the body to suggest that its practitioners were concerned with intellectual cultures because they indicated the powerful effects of materialism. It was a process that, in one form, was called ‘medicalisation’.

But as the New Left fractured due to violent militancy and state policing, to say nothing of the revelations of the Soviet Gulag and Chinese Cultural Revolution, and in light of the shifting focus of attention to the problems of gender, race and class, as well as human rights, much analysis moved toward seeking the roots of culture and power in more ideological and even philosophical terms. This is, of course, how Foucault came to be read, but other instances abound, such as Thomas Laqueur's deservedly influential Making Sex (1990). As his subtitle indicated, it explored ‘body and gender from the Greeks to Freud’. The new enterprise represented by such a work attracted much attention for questioning the analytical categories that had been assumed to derive from nature itself, showing that they were, rather, located in ‘cultural’ space and time rather than being fixed.Footnote ⁵ Comparative studies such as Shigehisa Kuriyama's The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine (1999) located differences of medical concepts in varying experiences of the body related to incommensurable cultural environments.Footnote ⁶ Studies such as this were widely interpreted to support studies in the social or cultural construction of science,Footnote ⁷ which were in turn associated with versions of postmodernism. They turned studies of the growth of objectivity into the making of subjectivities.

While suspicion about biology as the only thing that counts was liberating, doubts about scientific answers to historical questions have also had an additional consequence: some have felt free to overlook the material constraints on bodily life – including those that come through in examples of people trying out new drugs to see if they worked. Many of the ideological arguments of the so-called science wars of the late 1980s and early 1990s arose from objections to postmodern views that subsumed the body and other aspects of nature within the cultural or social, seeming to make a mockery of what was known to be real and fundamental.Footnote ⁸ As one of the proponents of postmodernist analysis, Fredric Jameson, put it,

For our purposes here, we can simply note that while Jameson saw postmodernism itself as the ‘cultural logic’ of late capitalism his point was that it had become possible to think about the world without regard to its material foundations.

There has been a strong push back, not only from scientists concerned about how cultural studies seems to demean their work by relativising all forms of knowledge, but from proponents of cultural studies of science who remained attentive to its materialist foundations. For instance, in the brilliant and mainly constructionist interpretation of colonial bodies offered by Megan Vaughan, she ‘kept intact’ some aspects of the history of diseases and bodies as ‘material reality’ despite feeling that by doing so she was committing what constructivists would consider a ‘cardinal sin’.Footnote ¹⁰ More recently, Bruno Latour wondered who his allies had become, finding especially troubling the example of powerful US neo-cons adopting arguments about science as a mere cultural construction in their attack on the ‘theory’ of global warming.Footnote ¹¹ Similarly, objections have come from some of the historians concerned about how ‘culture’ has dulled the edge of critiques of transnational capitalism. For instance, one group has not only attacked the development policies of the United Nations and World Bank, but implicated the cultural studies movement in their growing power: ‘Despite the evidence that culture is subordinate to economic interests and phenomena, scholars in cultural studies continue to avoid confrontation of material realities out of an anxiety about “metanarratives” or “foundational” principles.’ In other words, postcolonialism and postmodernism

In shying away from questions of material interest, then, ‘structural power’ goes unexamined, hence ‘disguising, if not celebrating, contemporary forms of power’.Footnote ¹²

For the moment, it is not necessary to engage further in contemporary polemics, only to remind ourselves of the following point: while the history of the body is – of course – strongly contested ground, among its original purposes were the exploration of questions about the cultural effects of economic formations. Such problems are worth another look.

The main shift in attitudes toward the body to be investigated here is well known: a shift from a discourse about how each person was unique to one in which all people were more or less interchangeable. Neither alternative was uncontested, since in some instances classical medicine allowed for the same thing to affect many different kinds of bodies (as in epidemics, for instance), while even the most modern clinicians are alert to individual characteristics when they are dealing with particular patients. But it is generally agreed that at earlier periods the dominant expectation was that the health and illness of each person emerged from their humours, age, sex, habits of life, environment, personal interactions and passions, probably together with their horoscopic signs, whereas in a more modern period health and illness have to do with the things all people share in common, such as certain kinds of bodily tissues, or certain kinds of caloric or nutritional inputs, or exposures to biological or chemical threats, and so on. The historical debate about the timing and causes of the change is broad and deep, running from how William Harvey's discovery of the circulation of the blood undermined classical physiology, to the rise of ‘mechanical’ physiology, to the Paris School and Xavier Bichat's pathology of tissues, to the rise of statistics, to cell theory and germ theory, to laboratory and hospital medicine, and so on – and that list simply includes a history of ideas, when state interventions for the control of human and animal diseases and many, many other kinds of causes could be invoked. Not surprisingly, the indefinable nature of the change is matched by the indefinable nature of the cause. But in a wide range of historical work, from Marxist-inspired historical sociology to professionally orientated accounts of the development of scientific medicine, there is wide agreement that a shift from seeing any person as naturally unique to naturally common is one of the marks of modernity.Footnote ¹³

Exploring the rise of the modern body is obviously a problem too large to tackle in a short article. But one way of narrowing the problem is to consider the causes of the recognised change from a physiological to an ontological view of disease. That is, on the one hand, disease may be considered to arise from the individualised physiology of someone when responding to their unique circumstances, or, on the other hand, to occur because of the encounter with, or introduction of, or ‘invasion’ or ‘attack’ of, a substance that disrupts the normal activities of the body, this later entity being the identifiable cause.Footnote ¹⁴ Duden's Woman beneath the Skin, with its emphasis on the experience of mysterious metamorphoses in female bodies in the eighteenth century, with protean afflictions that transform themselves from one manifestation to another, is a fine example of the articulation of the first, while Christoph Gradmann's Laboratory Disease, tracing out the ramifications of Robert Koch's encounter with bacteriology, is a distinguished example of the second.Footnote ¹⁵ I do not propose to define further either view, nor to offer an account of change that reduces past discourses and debates about the body and disease to a single cause. (In many histories of medicine, for instance, the iatrochemists of early modern Europe, especially those who followed Van Helmont, are often identified as the main proponents of the ontological view.Footnote ¹⁶) But an example of what was at stake is the famous claim made in 1676 by the well-known English physician, Thomas Sydenham, that diseases could be described in ontologically clear and distinct fashion according to their symptoms just as species of plants, such as an African violet, could be known by their attributes. Each might have individualistic variables but was clearly enough of the same kind.Footnote ¹⁷ Such orientations were supported in coming decades by Herman Boerhaave's call for careful distinctions between diseases, and the new subject of classifying diseases – nosology – exemplified by Linnaeus's Genera morborum (1763) and François Boissier de Sauvages de Lacroix's Nosologia methodica of the same year, with its classes of disease divided into orders, and genera, down to 2,400 species.Footnote ¹⁸

But this view of diseases was promoted by the medical marketplace, in which remedies were offered that would counteract diseases in anyone whomsoever. I do not wish to reduce newer ideas about disease to economic processes, but to argue that among the significant causes of change was commodification, a process that helped to give rise to a certain form of objectivity – one based on the careful description and analysis of objects. The medical literature of the early modern period is full of examples of medicines being tried out on human subjects to determine their universal efficacy, and this had implications for how contemporaries objectified the body. In other words, the causes for the increasing preference for the ontological experience of disease was not due to shifting medical ideas or ‘European culture’ alone, but was given a strong push from the development of a consumer market for medicines that would have similar effects on anyone who used them. Taking a look at how medicines were used is both an instance of the interconnections of ideas and practices, mind and body, and a reminder of the power of commerce.

We can begin such reflections about the interconnections between bodies, diseases and remedies with an illuminating special case: the acceptance in early modern Europe of medical ‘specifics’. It is only when diseases were well-defined entities rather than protean expressions of the state of the body at any moment that there might be hope for their elimination by the powers of specific remedies. As Sydenham put it, a specific could counteract a particular disease not by acting on a particular organ or humour but in general, and without ‘visible evacuation’ such as purging or sweating – or as his acquaintance Robert Boyle put it, specifics ‘are neither obvious to the sense, nor evacuate any gross, or at least sensible matter’.Footnote ¹⁹ To modern eyes, accustomed to taking tablets and pills intended to maintain or restore health insensibly, the use of specifics may seem like common sense; but to early modern ones, since most medicines ‘worked’ by producing dramatic physiological effects, and since they were usually supported by altered diet and regimen, while staying their ‘course’ might take many days, the subject could have no doubt about having been dosed.

One might say, then, that one ideal of ‘modern’ medicine is that its treatments be comfortable, targeted and available. And that they be good for any potential purchaser. Indeed, the medical advertisements of the period are rife with promises that pills could be had for a certain price that would infallibly cure this or that disease in anyone, and, as one of them put it, ‘may be taken in the hottest or coldest Weather, and hinder no business’. Or as another had it: ‘Speedy and Absolute Cure for the French Pox without Fluxing, or Confinement.’Footnote ²⁰ Such remedies also helped to support a more private bodily space, since medicines could be used without anyone else being the wiser. Although most intended specifics failed to convince established physicians of their intended benefit, hopes abounded. Robert Boyle, for instance, thought that many specifics were already known but needed to be sought out by learned people like himself:

He was seconded in 1752 by Pierre-Louis Moreau de Maupertuis, president of the Berlin Akademie der Wissenschaften: ‘It is quite by accident and only from savage nations that we owe our knowledge of specifics; we owe not one to the science of physicians.’Footnote ²² And indeed, some of the most famous remedies of the period, from cinchona bark to digitalis, and inoculation to vaccination, arose from the kinds of sources Boyle and Maupertuis had in mind.

It is probably therefore no accident that in the same text in which Sydenham wrote of diseases like species, he also wrote favourably about a specific, the Peruvian bark. Also known simply as the bark or cortex, or Jesuit's bark or, later, cinchona bark, it remains the most famous specific of the seventeenth century, no doubt because of its recent use. Knowledge of the bark can be found in Spanish texts of the sixteenth century by Juan Fragoso and Nicolas Monardes,Footnote ²³ but from the 1650s the bark became renowned for its curative effects against powerful intermittent fevers, then termed ‘agues’ in English and which we would today often call malaria, a frequent complaint.Footnote ²⁴ While shrouded in obscurity, the most likely origin of the medicinal uses of the bark in Europe is that one or more Jesuit missionaries in Loja (modern Ecuador, then part of the viceroyalty of Peru) reported the indigenous uses of the bark to Juan de Vega in Lima, physician to the count of Chinchon, who used it successfully and in turn sent boxes of it to Seville for sale.Footnote ²⁵ But the Jesuits themselves sent it on to Rome and began to market it – Jesuit pharmacies helped to underwrite the costs of the Society – and Jesuits were administering the bark in Rome by the mid-1640s.Footnote ²⁶ It made its way into the Spanish Netherlands and in 1652 was used to treat Archduke Leopold, who was relieved of his fever but, when a relapse occurred a month later and he would not take it again, he died. The various controversies and commentaries that followed indicate that by the mid-1650s the bark was becoming well known throughout Europe as a specific.Footnote ²⁷

In his first book, Methodus curandi febres (1666), Sydenham had agreed that the bark was a specific in cases of ague, although also expressing caution about its use because of the possibility of dangerous relapses if it were not used carefully; ten years later, in his Observationes medicae, he endorsed it heartily while by implication condemning all other touted specifics: ‘I am sure of this, that the only specific is the Peruvian bark.’Footnote ²⁸ In August 1678, he gave advice to his friend John Locke on how to use it, with particular attention to how to prevent the fits of the agues from returning by further dosing. ‘Thus you shall be sure to cure, for I never affirmed anything to you which failed.’Footnote ²⁹ Two years later still, his elaborated method for using the bark appeared in a published letter to Dr Robert Brady, in which Sydenham says that its use was his ‘sheet anchor’.Footnote ³⁰ But he also explains there that when the bark had been introduced to London twenty-five years before (about 1655), it had been held responsible for the death of an alderman and a captain – because, he thought, it had wrongly been administered just before an expected fit instead of afterward and was not administered for long enough after the first missed fit, which caused relapses – but guarding against both of these problems, he found it to yield perfect cures.Footnote ³¹ Other of his associates also came to take a keen interest in the bark, such as Charles Goodall, who was later mocked for his extensive direct sale of the bark in powdered form despite being one of the foremost physicians in attacking medical empirics.Footnote ³² Indeed, the bark had such powerful specific properties that by 1692 Richard Morton was proposing that it could be used to differentiate diseases, with those yielding to it being true agues and those that did not being something else.Footnote ³³

Another reason why Sydenham may have decided to make his views about the bark better known was its increased availability in the 1670s. Apparently a near monopoly on the supply of the bark via Jesuit sources had recently been broken, making it more affordable and so more popular. A book published in 1682 in Paris and immediately translated into English stated that ‘When it was only in the hands of the Jesuits, it was sold at Rome and Paris for Eight or Nine Shillings Sterling the Dose, which consisted only of Two Drachms’ (a quarter of an ounce). ‘But so soon as Droguists began to Trade in it, it began to fall in Price, so that Three or Four years ago, the best might have been had for about Forty Shillings the Pound weight’ (a drop of over sixfold). The market quickly rebounded, however, for ‘no sooner had the English Remedy to be in vogue, but men began every where to make Experiments with the Bark of Perus, which much enhanced the value of it’. M. Audry and M. Vilain, the two most famous druggists in Paris, sold out their supplies even ‘at the Rate of about Fifteen Pound the pound-weight’ (about the same as the original price of the Jesuits). ‘Nevertheless some small quantity came at length, but it was held up so dear, that it was like to have gone off at the rate of an Hundred Crowns the pound-weight’ (up to a far higher rate than the original), before regular shipments from Spain and Portugal and less demand stabilised the price at ‘4 or 5 pound the pound-weight’ (about a threefold drop from the initial price).Footnote ³⁴ Whatever the exact figures may be, the lowered purchase price would indicate a new source of supply beyond channels controlled by the Jesuits causing the bark to be far more widely available from the later 1670s, while at the same time there was pent-up demand awaiting it.

Sydenham may have been pressed into further endorsements of the bark not only because it was becoming popular, but because of the success of Robert Tabor (or Talbor). While in 1677 Sydenham failed to mention the bark after hearing from his friend John Locke that he had been suffering from the ague,Footnote ³⁵ a year later he wrote to Locke, still in France, with general advice about how to use the remedy. In doing so, he seems to be asking Locke to remember that he had found its benefits first: ‘Understanding how much Tabor, now knighted here, hath been admired for his skill in curing agues, I thought fitt to let you know’ how to use the bark, ‘if you have not allready observed it in my book, page 99.’Footnote ³⁶ He obviously expressed jealousy and possibly suggested plagiarism in further commenting that ‘I never gott 10£ by it, he hath gott 5000. He was an Apothecary in Cambridge wher my booke and practices never much obtenyed.’Footnote ³⁷ However Tabor had learned of the bark – and having apprenticed with an apothecary it certainly need not have been from Sydenham's book – he had perfected his method in the ague-infested Essex marshes, which brought him to the attention of the English king, gaining him an appointment as a royal physician; a book explaining his method (without revealing the details) quickly followed.Footnote ³⁸ The knighthood that provoked Sydenham's letter to Locke came on 27 July 1678. A year later, Charles II sent Tabor on a tour of the courts of Europe, apparently because of the rising interest in the bark. In Paris, he attempted to corner the market by buying up ‘all the Quinquina, that he could find at Paris, and the other chief Towns in France, and of England also’, but other practitioners began to obtain supplies via Rouen and Bordeaux, undermining his plans.Footnote ³⁹ He had more notable successes in curing the dauphine of France and the queen of Spain, Louisa Maria, of their fevers, while during Tabor's absence Charles himself had a fit of the ague at Windsor and recovered after being given the bark at the urging of Dr Thomas Short (one of Sydenham's acquaintances). In return for curing such people and revealing his secret, Louis XIV awarded Tabor the huge sum of 48,000 livres plus a pension of 2,000, along with the title of chevalier. He died a very wealthy man in 1681.Footnote ⁴⁰

Not everyone agreed that the bark was a specific, however. The response of the notoriously conservative physicians of France shows that clearly. Although the French king had ordered the publication of Tabor's practice, the book describing it actually reestablishes the authority of the king's senior physician by treating the specific as an ordinary simple (i.e. a single herb used medicinally). Published in French and immediately translated as The English Remedy: Or, Talbor's Wonderful Secret, for Cureing of Agues and Feavers (1682), the long version of the French title page hints at the alteration: With the Observations of Monsieur the Premier Physician to his Majesty on the Composition, Vertues, and Uses of this Remedy.Footnote ⁴¹ Authored by an entrepreneurial surgeon, Nicolas Blégny, the work not only presented Tabor's secret but added Blégny's own comments together with those of the premier physician Antoine d'Aquin (one of his patrons).Footnote ⁴² Its contents treat the bark not as a specific but as an ordinary herb, beginning with a thorough discussion of its nature and a list of all the problems it was good for. For example, the bark ‘often’ extinguishes the heat of hectic fevers and ‘all other internal Inflamations’ and generally acts ‘against all extraordinary and preternatural Fermentations; in a very short time it rectifies the depraved motion and the altered consistency of the mass of Blood, and it many times occasions . . . salutary evacuations’.Footnote ⁴³ Elsewhere, Blégny lists its usefulness in many conditions: ‘The most wonderful effects of this Febrifuge appears in all intermittent Feavers, which are its true object; for it stops, and in fine wholly Cures Quotidian Agues, Tertian, double Tertian, Quartans, double and tripple Quartans, and sometimes also other kinds of Feavers.’Footnote ⁴⁴ He also believes that a causal explanation is important, criticising Thomas Willis for saying that because the bark's action was not open to experiment ‘all that is to be done is to endeavour to understand and well observe the phœnomina that depends thereon, without troubling ones self with the efficient principles thereof’. Others, who did offer an account of how the bark worked, such as Nicolas Lemery's Cours de chimie (1675), had not got the explanation quite right.Footnote ⁴⁵ D'Aquin, however, had no trouble in offering a Galenic explanation: since fevers were caused by ‘depraved Chylification’, and the bark is ‘very Stomachical’, its action lay in how it helped digestion.Footnote ⁴⁶

As for recommendation on the bark's use, Blégny and d'Aquin also altered Tabor's practice considerably, reincorporating it within a Galenic system of individualisation, complexity and continual alteration depending upon the state of the patient's constitution. While Tabor had argued for simplicity of practice, the authors commented that the dose should be altered in consideration of the age of the patient, whether they have ‘a hot constitution’, and whether they are ‘much accustomed to Wine’.Footnote ⁴⁷ Thus, while the book continues to use the word ‘specifick’ for the bark, d'Aquin especially continually altered its use to accord with the individualist methods of treatment, regimen and diet that many learned physicians continued to defend. Indeed, he even complements Tabor on coming up with a more complex method of administering the remedy than the Jesuits had recommended (simply adding the powdered bark to wine). At the same time, however, he believed that Tabor had ‘disguised’ the bark, as other empirics did their drugs. Because he followed his rules ‘indifferently for both Sexes’, Tabor even had a misfortune in administering it to the dauphin, ‘whose Feaver proceeding from Vomiting and the weakness of his Stomach, was encreased considerably by the use of the Febrifuge’. D'Aquin also believed that Tabor erred in giving the bark ‘indifferently in all times of the Feaver’, and even killed people when he administered it to those suffering from continual fevers. Instead, it is necessary to use it together with ‘Diet, Blood Letting, and especially Purging’.Footnote ⁴⁸ D'Aquin not only gave recommendations for using it Galenically, but went on to advocate his own compound remedy as superior, mixing the bark with opium.Footnote ⁴⁹ ‘Hence one may judge how dangerous it is to trust the life and health of men, to the conduct of such kind of People’ as Tabor, ‘whose knowledge is always too much limited, to reach beyond the general Rules and Directions contained in their Receipts, and to descend into the exceptions that are indicated by sound judgment, experience, and the Principles of a judicious Doctrine’.Footnote ⁵⁰ In short, the English Remedy is not really about the bark as a specific but about D'Aquin's adaptation of it to the world of simples so as to bring it back within the older method of individualised dietetic medicine.

The division between physicians who continued to give great weight to dietetic medicine and those who gave more emphasis to universalised therapeutics created one of the most fundamental medical controversies of the period.Footnote ⁵¹ Of course, many did their best to straddle the fence by incorporating the best of both worlds,Footnote ⁵² while even a supporter of Sydenham might decide that the bark was not a specific but rather ‘the greatest Catholicon, or Panacea extant’.Footnote ⁵³ But ranged against the people like D'Aquin were those like Robert Boyle, who despite his caution commented that ‘it were to be wished, that there were fewer learned Men that think a Physitian hath done enough when he hath learnedly discoursed of the seat and nature of the Disease, foretold the event of it, and methodically imployed a company of safe, but languid remedies’ and dietetic advice, and more who were able to find and use ‘powerful Medicines’. The pursuit of new remedies would make treatment not only more effective but easy and painless.Footnote ⁵⁴ The bark fitted such ambitions perfectly.

While it would certainly be possible to explore further the debate about whether the bark was a true specific or not, or the full implications of the argument between individualist dietetics and universal therapies, there is for the moment one additional wrinkle to note: it was becoming common to decide on the merits of a therapy by trying it out on anyone. In such cases, almost any body would do. General conclusions were drawn, pace Blégny and D'Aquin, without concern to the temperament, status or conditions of the person(s) used for the experiment. A good example is how the emperor of China was convinced of the efficacy of the bark. Jean de Fontenay, who led a famous group of French Jesuits to China in the late seventeenth century, set down an account of what happened in a letter to father François de la Chaise, father confessor to Louis XIV, which was published in 1707. When Fontenay was called to the Chinese court at the end of 1692, he found the Kangxi emperor to be ill with a malignant fever. The Kangxi emperor is well known for having had a longstanding interest in European science, and he clearly had an interest in European medicine as well. He had already taken some of the lozenges that Louis distributed as a remedy to the poor in France, and felt better, but he continued to have fits of the ague. He therefore sent out a proclamation seeking to be informed of all cures for his condition and announcing that those suffering from ague could come to the palace to seek a remedy. Such patients were then subjected to trials of remedies, some of which were even made under the supervision of members of the emperor's family. In Fontenay's case, he and a fellow Jesuit, Claude de Visdelou, brought along a pound of the Peruvian bark that they had obtained from their brethren in India on the way to China, which they prepared according to their special methods. Three ordinary people who had suffered from ague were given it the next day, one of whom no longer had the fits, another who was given it in the midst of a fit and the third who was still suffering from periodic fits but was not experiencing one at the time he was given the remedy. After a period of observation at the palace, all three were pronounced cured. The four noblemen of the court who had supervised the trial then tried the bark on themselves to make sure that it had no ill effects on the healthy, and they afterward felt perfectly well and slept soundly. After these trials, the emperor himself took the bark and quickly recovered his health. In gratitude, the Jesuits were given many important privileges, including an edict of toleration and a residence inside the walls of the imperial palace.Footnote ⁵⁵

Such trials were clearly meant to be a form of public demonstration rather than professional discourse. That is, they were subject to consensus about the outcome based on what all the witnesses could know through their experience of the events rather than anything to do with private perception or learned categories. New drugs were tried out experientially because early modern people, at least, thought this was a good way to determine the effects of drugs. For them, common bodies spoke the truth. The phenomenon can be seen in many instances.

Although the precedents for experimenting on patients are very old indeed, the practice was certainly alive in the sixteenth century. For instance, Antonio Barrera-Osorio has carefully described how in the first decade of that century, a Spanish medical practitioner on the Caribbean island of Santo Domingo asserted he had found a local balsam that was the equal of, or even better than, the wonderful balsam known to classical medicine, and the Spanish crown itself became deeply involved in experimental trials to assess his claims.Footnote ⁵⁶ Another example from the same island is better known in the secondary sources: guaiacum wood, which was brought to Europe soon after Columbus founded Santo Domingo in the mid-1490s. It, too, was a remedy used by the indigenous people of the island to treat a common disease, and was adopted by the Spaniards following their example. According to legend, the local people of Hispanola who suffered from the chancres and other signs of what the Europeans would soon call syphilis were cured by water sprinkled from the branches of the guaiacum tree; Europeans came to associate the practice with the worship of Apollo, but imported the wood, shavings of which were taken in an infusion. In 1519, the noted humanist, Ulrich von Hutten, made it famous in literary circles by publishing a book about his own successful cure by the use of it: De guiaci medicina et morbo Gallico.Footnote ⁵⁷

Another example, that of the drug that replaced guaiac wood in the European pharmacopoeia as a remedy for syphilis – China root – in some ways prefigures the acceptance of Peruvian bark. The root of a deciduous climbing vine (Smilax) still widely used in traditional Chinese medicine, according to one mid-seventeenth-century account, ‘This Root was first known’ to Europeans ‘when the Chinese brought the same to be sold in the City of Goa, in India’, in 1535, from where the Portuguese shipped it back.Footnote ⁵⁸ The famous anatomist, Andreas Vesalius, wrote something similar three years after the first edition of his more famous De fabrica, in his Letter on the China Root (published in 1546): ‘It is imported by those who import pepper, cloves, ginger, and cinnamon, by Portuguese as well as by imperial seafarers.’ When Vesalius first arrived in Venice in 1537, he says, China root was used by many of the great medical professors. But there were two cases with ‘unhappy results’, which led to it falling into disuse before a physician arrived from Antwerp (Venice's great commercial rival with better access to Portuguese commodities), who said he knew the best method for preparing it, which revived its use. But the bishop of Verona died after starting on a course of China root, although the reason for his death was probably due to other causes, and it fell into disrepute again. Its popularity was then revived again, this time in Brussels, at the imperial court, where it was used in several cases against syphilis, although Vesalius himself thought it less successful against the disease than guaiac wood. Emperor Charles V himself had used the wood to treat his gout and generally poor health, but several Spanish bishops praised the root very highly, and thought the wood to be in disfavour, and (Vesalius implies) because the emperor was able to control his appetite only with difficulty – while the regimen that went with the use of the root was shorter in duration and less restrictive of his diet – they convinced the emperor to try it. Charles's successful use of it secured its fame.Footnote ⁵⁹

The famous Portuguese physician of Goa, Garcia da Orta, was undoubtedly one of those involved in the trade in China root. The famous book he published on the medicines of the east, published in Goa in 1563, explained that the root was very good against syphilis, but also helped ‘the Itch, Tremblings, Aches, Gout, &c. It is also very good for a weak Stomack, Head-ache, [and] the Stone in the Bladder proceeding from Cold’.Footnote ⁶⁰ A few decades later, at the end of the 1620s, a Dutch physician resident in the East Indies, Jacobus Bontius, gave personal testimony to its effects, praising China root as a wonderful treatment for the paralysis he endured during one of the sieges of Batavia (now Jakarta), as well as in other complaints.Footnote ⁶¹ By the later sixteenth century, another root, this one native to the New World, sassafras, was already seen as an alternative to China root, being found to be a very profitable commodity by Sir Walter Raleigh himself (following French and Spanish examples), and it became one of the main export products of the North American English settlements before tobacco and sugar overwhelmed its importance.Footnote ⁶² But it remained one of the commodities sought out in East Asia by the Dutch East India Company (VOC).Footnote ⁶³ Well into the later seventeenth century it maintained a reputation for being good in cases of syphilis, as well as for having ‘sovereign’ properties against ‘the Itch, Tremblings, Aches, Gout, &c. It is also very good for a weak Stomack, Head-ache, the Stone in the Bladder proceeding from Cold’, and would work without regard to diet or regimen.Footnote ⁶⁴

The list of new remedies introduced to Europe during the early modern period in this way – through empirical trial on oneself or others, usually in imitation of other peoples, and with implications for profit – is long. Many were held to be specifics against one disease or another while having uses in other cases. Just a few more examples to underline the point. In 1648 an Amsterdam physician, William Piso, published a lavishly illustrated book on the medicine and natural history of Brazil, where he had worked as a physician to Johan Maurits of Naussau during the Dutch period and probed into indigenous medicines. The local people used a root, ipecacuanha, as a remedy for the intestinal flux, and he highly recommended it.Footnote ⁶⁵ It became more widely known after a Dutch empiric, Jean Andrien Schweitzer, who Latinised his name to Helvetius, had great success in using it to cure the French dauphin of dysentery in the mid-1680s; it quickly became known as another specific.Footnote ⁶⁶ A decade later, when a Scotsman named William Cockburn obtained the position of physician to the Blue Squadron, he used his ‘blue powder’ on the sailors to cure cases of diarrhoea, claiming that his powder was even better than the ipecacuanha made famous by Helvetius. He gained the admiral's blessings to experiment on over 100 sailors with another powder in cases of flux, and had such success that the subsequent Admiral of the Blue, Sir Cloudesley Shovell, ordered it to be purchased in large quantities before he sailed for the Mediterranean. What the lords of the admiralty wanted, explicitly, were simple remedies that would be easy to administer and work successfully in all cases of a particular illness no matter the age or constitution of the patient – in other words, specifics. When the London College of Physicians objected that patients needed to be treated according to their constitutions and the circumstances of the moment, they lost their power to oversee the provisioning of the medical chests.Footnote ⁶⁷

As such examples indicate, then, conducting medical experiments on animals and humans in the interest of gaining universal remedies was not only common, but had the backing of princes and high-ranking military officers. A final example shows the interconnections: John Colbatch achieved medical fame, wealth and eventually a knighthood in the period following the Glorious Revolution in Britain due to his medical innovations. Beginning as an apprentice to an apothecary of Worcester, gradually rising to the rank of master in the Mercer's Company (to which the apothecaries belonged), he moved from Worcester to London sometime in the early 1690s. By the autumn of 1693, Colbatch was beginning to be known for his proprietary ‘Vulnerary Powder’ and ‘Tincture of the Sulphur of Venus’: that is, he was advertising a wound powder to stop bleeding and a tincture of copper sulphate to restore wounded flesh. He claimed to have found them empirically through self-study, chemical experiments and trying things out on ‘dogs and other animals’. The London surgical establishment, in the person of William Cowper, undertook a public trial of Colbatch's medicines on a dog, which he reported in the Philosophical Transactions of February 1694 as a success. But the subsequent trial on two human inmates of St Bartholomew's Hospital failed. Following an unsuccessful further trial on patients at St Bartholomew's, early in 1694 Colbatch obtained a pass from the government to go to the summer campaign in Flanders, where Major General Sir Henry Bellasis arranged for wounded men to be treated by Colbatch. He later claimed to have performed 100 experiments in the military hospitals, with only five miscarrying, the latter of which he blamed on his opponents. Colbatch kept the confidence of generals, and when he returned to Flanders again in the summer of 1695, he may even have gained the position of local surgeon-general during the siege of Namur. He obtained his knighthood from George I in 1716.Footnote ⁶⁸ Innovating a specific, proving it with trials on animals and human patients, and gaining fame, wealth and status thereby, was common enough in early modern Britain and Europe to be thought a major problem for the medical establishment.

One of the most powerful attacks on the learned medicine of the period was, therefore, a widespread and growing belief that each disease had a kind of ontological definition that made it distinct from other diseases – there would be no metamorphosis of one set of bodily expressions of illness into others – and that for each of these diseases there would be a regular treatment good in all cases, preferably a specific. The most widely accepted specifics were exotic imports to Europe, but the market was replete with new remedies that claimed to work infallibly and easily, since their producers might hope to obtain wealth and status from them. Clearly, demand for specifics was high. Some of the most powerful figures of the time were also keen on them, and were prepared to pay substantial sums to put them into common use.

But one consequence of this hope for effective universal remedies for particular diseases was that it treated all people alike. Specifics necessarily implied universality of effect. If they worked on hospital inmates, or soldiers and sailors, or ordinary people called to the palace, they would work on European admirals and generals, and well-to-do men and women, young and old, kings and emperors. Trying things out on those who had no voice would be of assistance to those who spoke freely. The emperor's body responded to the bark in the same way as those ordinary people on whom it was first tested in Beijing, in the same way as the indigenous people of northern South America who first used it on themselves. In other words, essaying simple trials of the effectiveness of drugs does not make much sense if each person's body will respond differently according to their particular temperament. (As an aside, it is worth noting that this is still a problem, especially in the make-up of experimental groups of subjects where until recently men were much more common than women, and adults than children, although the manifold problems of experimental trials are now usually addressed by statistics, which of course give probabilities rather than certainties, thus confusing many modern patients who think that scientific medicine is definitive.Footnote ⁶⁹)

If what I am proposing is correct, and the association between specifics and particular diseases was a common part of ‘traditional’ or ‘folk’ medicine in many places in the world, then what we are witnessing in the early modern period is not so much the rise of medical specifics or the universalisation or unitisation of the body as a decline in learned medicine due to market forces, which created commonalities among consumers. This movement toward thinking of people in the market as basically alike can be widely noticed. For instance, there were also changes in regimen. Late sixteenth- and early seventeenth-century medical books, even those in the vernacular, began by offering advice to the reader about how to determine one's temperament according to the system of the four qualities – and sometimes the signs of the sun, moon and planets as well – so that one could begin to think about a proper regimen for the maintenance of health or recovery from illness appropriate to the particular person.Footnote ⁷⁰ But alternatives were beginning to appear as well. For instance, one of the works by a Dutch physician on Java, Jacobus Bontius, On the Preservation of Health: Or Observations on a Sound Way of Life in the Indies in the Form of a Dialogue is based on the standard theme of the six non-naturals that effect health and disease – the air, food and drink, evacuations and retentions, motion and rest, sleep and waking, and passions of the mind – but gave recommendations for everyone.Footnote ⁷¹ He explains, for instance, the effects of the two seasons in the region – the rainy and the comparatively dry one – and the four parts of the day: the morning from dawn until about nine, when the air was temperate and breezy, allowing healthful work and exercise; the dangerous forenoon; the slightly less dangerous early afternoon, when it was best to rest; and the healthful period from about four in the afternoon until nightfall. These periods affected everyone alike, men and women, Europeans, South Asians, East Asians and the locally born Javans. And when it came to diseases such as leprosy, it was clear enough that regimen was not sufficient for treatment – a hospital was established to isolate the infected and to attempt treatment by other means. One of Bontius's successors, the physician Willem ten Rhijne – who first introduced acupuncture to a European audience – heard of a local practitioner from the island of Makassar named Sara Jagera who had a reputation for curing the disease, and in 1691, invited him to come to the leprosarium in Batavia to undertake trials on the inmates. Only Jagera's death prevented the experiments from coming to completion.Footnote ⁷²

In other words, long before the so-called clinical revolution in Revolutionary Paris, hospital patients and military servicemen were being used as experimental subjects, while ordinary people, even the powerful and well-to-do, advocated new specifics – and this sense of universal applicability to anyone can be noted in shifting recommendations for regimen as well as in those for medical treatment. Much of the new medicine was based on a love of the exotic and a taste for the novel, something that must be associated to a large extent with the new global commerce of the period. But it also encouraged the desire of ordinary people to hope for a remedy for any ill that could be purchased in the market. All of this implied that what was good for one person was good for anyone else, undercutting the elaborate methods of individualised treatment and regimen so long favoured by the learned physicians. It also favoured not only medical empirics but the scientific virtuosi of the Royal Society and people like the apothecaries, whose reputations depended on their knowledge of the natural particulars they sold to the public. In England, therefore, the beginning of the eighteenth century famously saw the House of Lords decide that apothecaries could legally practise medicine, even if they were not educated in the niceties of learned physic.Footnote ⁷³

A universalised and materialistic humanity was being built from the wheels of commerce and articulated by the new ideas of the so-called scientific revolution. Contemporary medical empiricism included trialling new remedies on experimental subjects, and the connections between empiricism as both an attack on the last vestiges of academic physic and as salesmanship for specific drugs were obvious. The underlying premise coming into focus through such activities was that all people possessed a common biology. Scientific racism would have to find new kinds of distinctions – but that is another story.

A last historiographical reflection, then: since Jacob Burckhardt, modernity has been associated with the rise of expressive individualism; at the same time, his exact contemporary, Karl Marx, who also associated modernity with the rise of the bourgeoisie, considered that what was important was not the individual but the fetters of materialist laws of nature to which all people are subject. More recently, in the contrast between the carnivalesque of Bakhtin and the discipline of knowledge-power found in Foucault there is something similar – to say nothing of the frictions between historians of science, medicine and technology who focus on the development of new ideas articulated by individual minds and those who see institutions and social systems at work. One can see both sides of the coin at work, too, in the medicinal empiricism and experimentalism of early modern Europe: both individualist entrepreneurialism and fundamental social change. The coin of which these two sides are emblems was composed of material values evident in worldly wealth generated in part from global commerce, a part of which in turn was the flourishing international trade in medicines. Commerce indeed helped to create the modern body.